Restore: A Peer Facilitated Model For Substance Use Disorder Care Integration Into Outpatient Infectious Disease Care

Author: Oluwaseun Falade-Nwulia Tracy Agee Ju Park Sharon Kelly Nicholas Schweizer Jeffrey Hsu

Theme: Models of Care Year: 2022

Background: The opioid crisis has led to concomitant increases in injection drug use and infectious
diseases such as hepatitis and HIV. Models of care to integrate SUD care into infectious disease (ID)
care settings are needed. The RESTORE program utilized a multi-component approach that includes
screening, linkage to SUD care through peer-delivered engagement, and initiation of evidence-based
SUD treatments by ID care providers to integrate low-barrier SUD care into an outpatient ID care
Methods: Participants were recruited from patients receiving RESTORE services between April 2019
and July 2021 (63% HIV only, 23% HCV/HBV only; 11% HCV/HBV and HIV). Paired sample t-tests and
McNemar’s tests were conducted to compare substance use, injecting behaviors, and mental health
scores (GAD-7 and PHQ-2) from baseline to 6 months.
Results: 137 participants with a mean age ± SD of 52.1 ± 10.4 years, 63% male, 84% AfricanAmerican were included in the study. The majority, 127 (92.7%) were retained at 6 months. In the
paired sample (n=127), significantly fewer participants used any illegal opioids in the past 30 days at
6 months (32.3%) compared with baseline (52.0%; p<.001). Heroin use in the past 30 days decreased
from baseline (47.2%) to 6 months (26.8%; p<.001), as well as fentanyl (31.0% at baseline vs. 19.7%
at 6 months; p=.009) and cocaine use (46.5% at baseline vs. 33.9% at 6 months; p=.006). The
proportion of participants who injected in the past 30 days also decreased from baseline (12.6%) to
6 months (7.9%; p=.03). Additionally, significantly fewer participants screened positive for
generalized anxiety disorder from baseline (22.2%) to 6 months (9.5%; p=.004).
Conclusion: Study findings suggest effectiveness of the RESTORE model for SUD care integration into
an urban outpatient ID care setting. More research is needed to examine RESTORE’s effectiveness in
other settings with different demographics, including rural communities.
Disclosure on interest: None

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